Deep Second Degree Superficial(DIIS) Burns Wounds Treament

According to pathological and  clinical  manifestations, deep  second-degree burns  can  be divided into  injury  on the  dermal papillary layer  and  injury   on  the  reticular layer, or simply referred to as deep second-degree superfi- cial (DIIS) and deep second-degree deep (DIID) burns.


Clinical signs include wound  pain,  extensive blisters, wound  without blister  skin becoming red and  white,  the superficial dermal tissue  is necrotic and  turns  white,  the surviving deep dermis tissue  is red, while under pressure 

it turns  white and soon returns to red after release of pres- sure (DIID burns wounds respond more slowly). The exu- dates of the wounds are only less than  those of superficial second-degree burns.

BRT with MEBT/MEBO treatment and clinical mani- festation: It is a four-period process:  firstly,  treatment in the early stage (shock period), same as that  for superficial second-degree burns;  secondly, liquefaction and rejection period of necrotic dermal tissue  (rejection period); third- ly, regeneration and recovery period, and,  fourthly, reha- bilitation  period  of  skin   physiological function  after wound  healing.

First  Period.  The  treatment of the  first  period is the same as that  for superficial second-degree burns, empha- sizing  on  wound  protection. A thin  layer  of soft  mem- brane may appear on the wound free of putrid or blistered skin.  The  next  treatment period starts  on day  4–5 post- burn when the wound  edema diminishes gradually.

Second  Period.  Clean  away  the  putrid skin,  blistered skin  or thin  soft membrane in the  same  way as dealing with superficial second-degree burns. Continue the appli- cation of MEBO.  Gradually, the necrotic layer of wound surface begins to liquefy from the superficies to the interi- or and produces white liquefied products floating over the wound   surface.   Usually at  3–4  h  after   application of MEBO,  the wound  is totally  covered with  whitish lique- fied  products, indicating that  MEBO  is consumed com- pletely.  The liquefaction products must  be cleaned away before the renewal  of MEBO. Another 3–4 h later, the re- newed  MEBO  is consumed again  when  the  liquefaction products float  over  the  wound. Clean  the  liquefaction products, renew  MEBO  again  and  keep the clean-renew- clean  process  going until  the necrotic tissues  are entirely liquefied and discharged. This process generally occurs 5– 15 days postburn. Patients with large-area burns are urged to turn  over during drug renewal.

Third  Period.  After  the  second  period treatment, the chestnut-like residual dermis tissues,  millet-sized, are ex- posed  on the basal  layer of the wound. Continue MEBO with  less  thickness directed  under  BRT  with  MEBT/ MEBO and renew every 4–5 h (every 6–8 h at night). Cov- ered and  protected by MEBO,  the residual dermal tissue reconstructs and regenerates. Once dermis tissue regener- ates   to  smooth  skin,   less  irritation  to  the   wound   is allowed.  Again reduce  dosage and renewing  times  as long as the wound  is not dry, but crust formation is forbidden, i.e.  not  only  prevent wounds from  being  macerated by MEBO, but also avoid  the wounds becoming dry and get- ting covered by a crust. Duly keep the normal skin around the wound clean. For large-area burn patients, do as in the second  period by helping  them  turn  over regularly  on the basis of drug change intervals. The pressured parts  of the body  still  need  MEBO  protection till  the  wounds heal. This period occurs 15–20 days postburn.

Fourth  Period.  Although the  wound   heals  after  the third stage,  the  functions of the  newly  healed  skin  still need  to rehabilitate completely. The  epidermis requires further  physiological adjustment  and   metabolism;  the sebaceous glands need compensatory metabolism; the ex- cretory  duct  of the sweat gland is not yet clear; the func- tions of pigment cells are unable to meet the requirements of normal skin. Under these circumstances, MEBO is still necessary to be used as a skin-care oil for another 10–15 days. Or apply newly developed MEBO series products – MEBO  Cleansing Cream to promote quicker recovery of skin  function, or apply  MEBO  Itch  Relieving Cream to stop itching.

Clinical signs include wound pain, extensive blisters, wound without blister skin becoming red and white, necrotic or white superficial dermal tissue, and red survival deep dermis tissue.
A thin layer of soft membrane may appear on the wound. Reserve the layer of membrane and continue applying MEBO every 4-5 hours every day.
Five days later, clean the membrane and redress complying with the principle of 'Three No'.
The necrotic tissues are all liquefied and discharged from wounds 10-15 days postburn.
20 days later, wounds regenerate and repair to heal.
Continue applying MEBO for 10-15 days as protective oil until skin functions are restored to normal.

1. On 1st day postburn wounds  are   superficial II degree burns mixed with deep II degree burns. There are blisters in different sizes. 

Release water in blister and retain blister skin.

mebt mebo treatment deep second superficial burn

2. Apply MEBO directly and protect wounds.

mebt mebo treatment deep second superficial burn

3. On the 3rd day postburn, apply MEBO on wounds. Edema fade away and a layer of soft membrane forms on

mebt mebo treatment deep second superficial burn

4. On 4th day postburn, superficial II degree burns gradually heal. 

Necrotic tissues are liquefied on deep II degree superficial type wounds. 

Redress MEBO every 4 hours (6-8 hours at night) and remove the soft membrane.

mebt mebo treatment deep second superficial burn

5. On 8th day postburn, deep II degree superficial wounds continue being liquefied. 

Clean the liquefied products and necrotic skin complying with the principle of "Three No" before redressing MEBO.

mebt mebo treatment deep second superficial burn

6. On 12th day postburn, necrotic tissues are liquefied and discharged. 

Under protection of fabric isolating membrane, wounds are repaired to heal.

mebt mebo treatment deep second superficial burn

7. On 15th day postburn, most wounds are repaired to heal.

mebt mebo treatment deep second superficial burn

8. On 25th day postburn, all wounds heal. 

Continue using MEBO as protective ointment for 10-15 days until skin functions are restored.

mebt mebo treatment deep second superficial burn